Taking a closer look at the fine print and costs of implementing UV-C technology

While UV-C technology offers a quick way to effectively disinfect surfaces in healthcare settings, there are some limitations, says John Scherberger, owner of Healthcare Risk Mitigation, a Spartanburg, South Carolina-consulting firm aiding healthcare facilities in infection control. When the technology is used, he says it’s necessary to also add staff to run the equipment.

“If someone asks me if this is good technology, I say, ‘Yes.’ But is it good to be used everywhere? My answer is ‘No,’” he says. “I know of one environmental services director whose hospital purchased three units. He had to hire three full-time employees to operate them and move them around the hospital. I do not think that’s an efficient use of personnel. As soon as someone walks into a room disinfected with UV-C rays, it’s contaminated. To look for a completely sterile environment is impractical.”

Bates admits their facility has had to dedicate staff to UV-C system use in order to employ the device 24-hours a day. The healthcare facility has four people operating it around the clock, every day but Saturday, in public areas and rooms with known infections. That being said, he maintains the system will pay for itself and the employees needed to run it by lowering HAIs.

“If you are going to do this, you will need a full-time person running the program,” says Bates. “You cannot just add the technology and think ‘This is wonderful. We will use it when we have time.’ You have to be dedicated to using it 24-hours a day. If you can’t do that, you probably shouldn’t get into it.”

He adds that the benefit comes in the form of reduced infections and the issues associated with HAIs. Those benefits far outweigh the costs of the equipment and additional staff.

But Scherberger is quick to add that the equipment isn’t the have-all-end-all executives may think it is. Before it can be used, the room must be cleaned and prepped prior to running the system.

“Workers have to move the curtains, take things off of walls, anything that prevents the UV-C light from bounding off of surfaces,” he says. “If the light on the machine cannot reach the surface, it cannot disinfect it. And quite honestly, light on these machines cannot get underneath every nook and cranny in a hospital room.”

Arzaga agrees, noting that this is an issue that can be overcome once the hospital puts proper procedures in place. Jewish Senior Living Center first performs a terminal clean in the room then they prep the room and decide where to start with the UV-C system, doing the dirtiest areas first. Cleaners open drawers and cabinets, expose telephones, remote controls and other high-touch surfaces, he says.

“We average two to three treatments in a room because we have to move around,” he says. “Generally it’s two — once in the restroom and then in the patient room.”

Likewise, patients and healthcare workers shouldn’t be in the area when the UV-C system is working. This issue is overcome at Jewish Senior Living Center by placing warning signs outside the room being disinfected, and notifying staff prior to turning on the unit. Arzaga adds that the system can be activated by remote control, that it gives a 15-second warning before it begins operating, and it shuts off automatically if any movement is detected.

“The system also has a green light showing it is operating and emits a pulsating sound as it works,” he says.

Although numerous studies support the use of this technology for disinfection, Scherberger worries that the systems might evoke a false sense of security, causing hospitals to clean the rooms less carefully than they did before.

“Executives need to make sure their staff not only cleans, but they clean and disinfect,” he says.

Bates agrees, adding that the systems do not replace good old-fashioned cleaning with chemicals.

“This technology compliments cleaning,” he says. “It is an additional tool that helps in the cleaning process. Chemicals report a 99 percent kill, but in reality, I found it’s more like 75 percent. Adding this technology gets us closer to that 100 percent kill.”

To make sure the technology is working as promised, Jewish Senior Living monitors the effectiveness of their UV-C treatments by using ATP meters pre-treatment and post-treatment. The results of testing revealed an almost 100-percent kill after the UV-C technology is used. 

Bates also warns that as the industry moves into the sixth and seventh generation of quaternary cleaners, or quats, UV machines may soon become a necessary technology in the cleaning process.

“We are going to get to a point where what we are using to kill germs is not going to be effective, and by adding UV-C technology we can do a significant germ kill,” he says.

That being said, Scherberger says he’s still not convinced that this technology is right for every hospital. The Association for Health Care Environment recommends hospitals set aside 35 minutes to an hour for terminal cleaning now, without these systems in place. Adding time to this process, when hospitals are already pressured to turn around beds as fast as possible, leaves Scherberger scratching his head.

“It really depends on the population, the length of stay and the census of the hospitals,” he says. “For a hospital running in the high 90s, I don’t think it’s practical. They need those rooms. If a patient is moved from the operating room or is a direct admit, it makes no sense for them to be hanging out in the hall while the room is being disinfected. Adding another 30 minutes to process a room boggles the mind.”

Whether environmental service executives opt to implement this technology or revamp their chemical disinfection programs, they should be actively looking for ways to reduce HAIs.

According to a 2014 CDC report, there were 722,200 confirmed cases of HAIs in 2011, 75,000 of which resulted in deaths. In an effort to reduce these statistics, hospitals are required by the Department of Health and Human Services to report infection data to the CDC. The results of this reporting will determine whether that hospital will be paid by the Centers for Medicare and Medicaid Services. 

RONNIE GARRETT is a freelance writer based in Fort Atkinson, Wisconsin.

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